Health care is changing rapidly. Integration of care for the physical, mental health, substance use, and social needs that affect health is requisite. Reimbursement for these services is evolving from paying largely on a fee-for-service basis to measuring the quality of care delivered and rewarding or penalizing providers based on the outcomes that are achieved. New services delivery structures such as Accountable Care Organizations (ACOs) are emerging to achieve these goals.
These realities call for a new and different approach to behavioral health care and social services. We believe that the greater MetroWest region, with its diversity of service providers who have a long history of collaboration, can serve as a pilot that other parts of the state will one day replicate.
With generous funding from the MetroWest Health Foundation, CHNA 7, and the MutualOne Foundation, our agencies have come together to form a new entity, Behavioral Health Partners of MetroWest, LLC (BHPMW). The BHPMW will serve as a single point of entry for individuals and families seeking access to the full range of behavioral health and social services offered by all four agencies. Equally important, others involved in their lives and care, such as primary care physicians, ACOs, health plans, and schools, will have the same quick access to make referrals and secure services.
All four agencies are effective providers of community based outreach, engagement, care coordination and integrated care management with many populations. We each have particular strengths and specializations – encompassing mental health, substance use, and social determinants across the lifespan – and this will not change. BHPMW will not replace the direct services or existing referral procedures offered by the member agencies.
BHPMW will create easy access for families urgently trying to get help. The families we serve often have complex needs that are part medical, part social, and often result from having limited resources. Rather than requiring these families to place multiple calls to locate the right agency and the right service, BHPMW, with its toll-free line and website, will enable families to make just one call.
The trained staff on the other end of the phone will determine what the particular need is and their knowledge of the available resources will enable them to make an immediate connection for the family. This will save time, alleviate (if not eliminate) frustration, and prevent the trial-and-error approach to finding services that can have a detrimental effect on those who need care. In addition to providing improved access to services at the outset, BHPMW will provide care coordination until the individuals are connected to all the services and supports they want and need.
Beyond the myriad benefits to individuals and families, we believe this collaboration is consistent with the broader transition in our health care system to more vertically integrated care. Here in Massachusetts, MassHealth is embarking upon a transition where care will be provided under risk arrangements with ACOs that will include hospital systems, health plans, and community health centers.
These ACOs will need partners that can provide the type of integrated behavioral health care that ensures people get the right care, at the right time, in the right setting. BHPMW is poised to provide that level of partnership.
The challenges that we face in health care today, particularly behavioral health care, are great and resources are no doubt constrained as policy makers grapple with the rising cost of health care. As a provider community, we have been asked to do more, and do it better, with less.
This requires new ways of solving the puzzle, including strategies that might not even have been imagined just a few years ago. Our human services provider community is collegial, and we are also competitive. We all pursue a finite amount of public funding.
Our four agencies reached the conclusion that we must collaborate to truly succeed with those whose care is entrusted to us. This collaboration does not mean losing our independence or our unique strengths.
It does, however, mean coming together with a new method – a new entity, even – to get people the care they need sooner, while also better understanding how our system can best serve them. Pursuing these kinds of solutions is why we all got into this field.
James T. Cuddy is Executive Director of SMOC, Diane E. Gould, LICSW is President & CEO of Advocates, Kurt Isaacson is President & CEO of Spectrum Health Systems, and Eric L. Masi, Ed.D, is President & CEO of Wayside Youth & Family Support Network.